Incorrect fixes to Tampa and the country’s organ transplant system

Few medical procedures to save lives that rely heavily on partnerships and coordination as organ transplants. The moment when a patient receives a potential organ call is possible, as a grieving family agrees to give a gift of life during an incredibly vulnerable time. The dedicated organ procurement organization then works with the hospital to enable that miracle.

There are so many things to be proud of here in Tampa Bay. In 2024, the Tampa General Transplant Institute led the country with transplant volumes and performed 889 life-saving transplants, including 500 kidneys, 279 livers, 51 hearts and 42 lung transplants. This success is built on a strong collaboration between our transplant center and our community sourcing organization, Lifelink, Florida.

The story of this collaboration is reflected nationwide as records continue to break in organ donations and transplants. But looming uncertainty threatens to disrupt this progress.

In 2020, the Centers for Medicare and Medicaid Services introduced regulatory rules that could close more than half of the country’s 55 organ sourcing organizations. These organizations serve as important links between donor families like me, hospitals and transplant surgeons. The potential impact on patient care is important.

While its intention to increase accountability and improve results is commendable, implementing this rule ignores long-standing peer-reviewed science that shows significant statistical flaws in its performance metrics. For example, the science of donations and porting that I serve on the advisory board has compiled the robust body of this research on its website.

In 2024, Health Resources and Services Management censored a study that critically analyzed the Center for Performance Metrics for Medicare and Medicaid Services in Organ Procurement Organizations. This action raises serious concerns about transparency and suppression of scientific discourse.

This is not a partisan issue. Concerns about regulatory oversight in this sector have continued across multiple administrations for decades.

What is needed is not a punitive or hostile approach. Instead, there is something that promotes collaboration, innovation, and shared accountability. The organ procurement organization for transplant centers does not serve patients or donor families here to support us all.

Here in Tampa Bay, we have demonstrated that effective collaboration between transplant centers and procurement organizations can save lives. That should be the national model. I’ve practiced in both New York City and Tampa, so I’ve seen how every region can bring something valuable to the table. No one monopolizes good ideas. But together, we create something larger than the sum of the parts.

None of us claim that the current system is perfect. However, the United States has been able to build the world’s most sophisticated and successful organ and tissue transplant system, saving more than a million lives to date.

Unfortunately, the current Centers for Medicare and Medicaid Services do not provide meaningful support for procurement organizations to help improve or recruit best practices. It also overlooks the academy of the 2022 science, engineering and medical landmarks for modernizing organ donation systems. This was a report mandated by Congress, but it has been largely addressed.

Yes, some procurement organizations need improvement. However, there is no evidence to suggest that more than half of these important organizations should be dismantled. This is not particularly true while progress is accelerating at a local level. Doing so will put risks in a system that will introduce chaos and litigation and thrive with coordination and trust.

The Centers for Medicare and Medicaid Services should work to rebuild trust with the stakeholders of the system and approach regulatory responsibility in the spirit of collaboration and discovery. Teamwork between transplant centers and procurement organizations save lives. We are in the trench together. When a procurement organization receives a 2am call from the hospital about potential donors, we know that their team is looking for our patients and explores all viable ways to turn tragedy into a life-saving gift.

Let’s make sure our regulatory approach reflects the same spirit. It’s one of our shared commitments to collaboration, trust and saving lives.

Anthony Watkins, Maryland, is the Surgery Director of the Kidney and Pancreatic Transplant Center at Tampa General Hospital. He also serves on the Scientific Advisory Committee on Donations and Transplants. He is the only view expressed in this work, and does not necessarily reflect the views of Tampa General Hospital or the Tampa General Transplant Institute.